The Nursing Chronicles Part 2: Thrush & Tongue Tie

Last week I posted Part 1 of my Nursing Chronicles, where I detailed the first 2 weeks of our breastfeeding experience.  To sum up my last post, Sami had chronic latch problems due to a number of factors.  In addition to our latch issues, I developed mastitis within one week.  After being prescribed a round of antibiotics to treat the infection, I began noticing little white patches in Sami's mouth which I suspected were oral thrush...

SAMI'S 1 MONTH CHECK-UP + ORAL THRUSH

A week after I started noticing the white spots in Sami's mouth, we went to his 1 month checkup where the pediatrician confirmed that he did indeed have oral thrush.  She prescribed him an oral suspension of the anti-fungal Nystatin to be given 4 times a day using an oral syringe.  I absolutely despised the idea of having to give him any sort of medication, but she said it should take care of the yeast overgrowth before it got out of hand.  His pediatrician also said that I could put the Nystatin on my nipples after nursing him as a precautionary measure.  In addition, she advised that we should boil or sterilize all pacifiers, toys, & nipple shields on a daily basis - essentially anything that came into contact with his mouth.

As I mentioned in Part 1, I also developed a vaginal yeast infection as a result of the antibiotics.  Luckily, it was easily treatable with an over the counter kit, but Sami's oral thrush turned out to be much trickier to get rid of.  Moral of the story: do anything you can to feed the good bacteria in your body while taking an antibiotic.  Try to eat lots of yogurt, take a probiotic, limit sugar, etc. - whatever you can do to avoid thrush and/or a yeast infection.

Before administering Sami his first dose of the Nystatin, I decided to try it for myself.  I couldn't believe how sweet it tasted.  I was under the impression that yeast feeds off of sugar, so it seemed a bit counterproductive to me to treat thrush with a sugary medicine...but hey, I'm no doctor -what do I know.

We gave Sami the Nystatin religiously, but did not see any improvement.  In fact, I began noticing that my nipples were becoming even more sore & sensitive than they were before.  Within a few days, I couldn't stand ANYTHING touching them.  I couldn't stand the water from the shower head, I couldn't dry off with a towel, couldn't stand wearing a bra or a shirt.  You name it - I couldn't stand it.  Nursing was excruciating.  It burned & it felt like I was being stabbed with shards of glass the entire time.

6 WEEK OB CHECK-UP

Thankfully, I had my 6 week follow up with my OB, where I was able to ask her about the additional pain I was experiencing.  She said that it appeared as though the thrush in Sami's mouth had transferred to my nipples.  She prescribed me a topical Nystatin that I was to apply in between feedings.  It's not safe for infants to ingest however, so I had to wipe it off with a warm washcloth before every feeding (which was super painful).  Then after every feeding, I had to wipe them down with a vinegar solution, let them dry, & then apply the Nystatin cream (vinegar solution = 1 Tbls white vinegar + 1 cup water).  She reiterated how yeast loves to thrive in dark & moist areas, so I would need to keep my boobs as dry as possible.  I also had to wash bras & bath towels on a daily basis in hot water & dry them in the sun if possible (since sunlight kills yeast).

My OB also reluctantly gave me a prescription for Fluconazole (Difulcan).  She told me to try the Nystatin first, and if I didn't feel better after two weeks I could then try the Fluconazole pills.  I also finally decided it was a good idea to start taking a probiotic, eat more yogurt, & limit my sugar intake - which I should have done from the beginning.

Unfortunately, after about a week I saw no improvements in either my or Sami's condition.  It was beyond frustrating.  At that point, I dreaded nursing him so much that often times, I would cry just in anticipation of it.  This is coming from someone who has a fairly high pain tolerance - I was able to endure natural childbirth, but nursing with thrush & a horrible latch was truly almost as bad.  Another week went by with no marked improvement, so I decided to try the Fluconozale.  After several rounds, I still felt no relief.  Despite my best efforts, we could not seem to get rid of the pain & the thrush.

Some of you might be wondering why the hell I didn't just pump & bottle feed, or throw in the nursing towel all together.  Like I mentioned in my last post, I was really nervous in regards to nipple confusion & didn't want to risk losing our breastfeeding relationship.  Most of all though, I was extremely determined to make it work & I didn't want to give up on it just yet.  That being said, I 100% understand why so many moms choose to stop breastfeeding earlier than they had hoped for - there are SO many challenges that you can come up against.

In addition to the thrush, we continued to have latch issues despite using the nipple shield intermittently.  It seemed as though Sami perpetually had a shallow latch & would even make very faint clicking noises when he nursed.  He also popped off frequently as well.  I felt like as though we were still struggling way more than we should have been after 2 months.  I originally wanted to breastfeed for a year, but at that point, I was skeptical that I would even be able to make it to 6 months.  It was definitely time to seek outside help & schedule an at home lactation consultation.

AT HOME LACTATION CONSULTATION

The at-home visit was not covered by our insurance, but I was more than willing to pay the $250 to get some help & answers.  The LC was super nice & asked me what my main concerns were.  I gave her a brief synopsis of our history & explained that I was still having problems with basic nursing positions, latching, thrush, pain while nursing, and pain & sensitivity when not nursing as well.  By that time, I was also convinced that he did in fact have a tongue tie that was severe enough to prevent a proper latch.

She took a look in Sami's mouth & confirmed that he not only had a tongue tie, but a lip tie as well!  Once she explained how the tongue & lip ties were affecting his latch, it all made perfect sense!  The tongue & lip ties explained why he always had such a shallow latch, had trouble making a good flange with his upper lip, & made clicking sounds when he nursed (you can read more on ties here).  She recommended that Sami have both the lip & tongue tie revised through a frenulectomy as soon as possible.

The LC even seemed a little surprised no one had suggested it sooner.  I explained to her how we had discussed it with both our first LC & pediatrician, but neither made us feel as if we needed the procedure to correct it.  I also think a key reason no one felt an urgent need to revise his tongue tie was because he was actually gaining weight at a normal rate.  Typically, babies with tongue/lip ties or latch issues also have trouble gaining weight, which signals an alarm that something must be wrong.  The lesson here is that even if your baby is gaining weight normally, that doesn't mean there aren't underlying problems.  If something doesn't feel right, you should trust your gut & get another opinion.

The next topic the LC went over with me was nursing positions & holds.  First, she wanted to observe us & see how we did things normally.  So I began to build my little pillow fort & started nursing.  Right away, she noticed how uncomfortable I looked sitting so upright & I explained to her how I felt as though I needed to sit up so straight because it gave me more control of his head & neck while getting him latched.  She said I should try "Laid Back Nursing" & recommended I watch some Nancy Mohrbacher videos.  I tried to give it a shot, but holy hell, did it feel awkward!  I could just feel myself tensing up as I tried to get him latched - it did not feel comfortable at all.  I think it's important to note that the majority of my tension & apprehensiveness with latching was a result of my anticipation of the pain.  I would venture to say if you are not having nipple pain you might have an easier time relaxing into a laid back nursing position.

I also explained that we were still suffering from thrush.  When I told her the Nystatin wasn't working, she suggested that we try Gentian Violet instead.  At the end of our consult, she gave me a couple of names of some pediatric ENT's in the area & told me to book an appointment asap.  It felt so good to finally have a game plan, and potentially, some solutions to our breastfeeding problems.

I'm going to end Part 2 here & pick up in Part 3 where I'll go into the next phase of our nursing journey which includes our experience with a frenulectomy.  On a side note, if you are having troubles breastfeeding, I would definitely recommend an at-home lactation consultation, because they can assess you in your environment.  I truly believe it was money well spent.

As always, let me know if you have any questions & thanks for reading!
Mel